The meds debate: Understanding the misunderstandings

Thursday

Jul 25, 2013 at 12:01 AMJul 25, 2013 at 6:00 AM

By CRAIG D. WEISS

J.D. Mullaneís columns on ďHappy PillsĒ conjured up strong and angry feelings for him and those who disagree with his negative assessment of mental health medications and the people who take them. There are a few fundamental misunderstandings on both sides, the first of which is the belief these medications can make anyone happy. Most of the time they donít, and as Mr. Mullane correctly points out, ďYou are as happy as you decide.Ē

When people in significant emotional or psychological distress take prescription medications for symptom relief, they donít usually become happy. I donít know that should ever be a goal of the medication. Once the symptoms of significant anxiety, depression or ADHD are reduced or relieved, itís up to the individual to find happiness. Maybe itís been there all along, buried under the mental disorder, or maybe they need to work on it themselves or in therapy. Itís easy to lose who you really are when you suffer from a bona fide emotional or psychological illness. Finding happiness within yourself is usually the toughest part of mental health treatment.

The second misunderstanding is what constitutes good, or necessary, mental health treatment. The number of people in the United States receiving some type of treatment is exploding, while the amount spent on the treatment is declining compared with other health care services. That seems to make no sense until we account for the push from pharmaceutical companies and health insurance carriers for prescription medication.

Mental health medication advertisements depicting happy people are in magazines, television and the Internet and target teens, parents and adults. With increased demand and MH treatment becoming socially acceptable, itís less expensive for insurance companies if family physicians write a prescription a few times a year than it is to pay for weekly psychotherapy sessions.

A third misunderstanding is perhaps the most important: What is unhappiness, or discomfort, and how do we, as a society, learn to tolerate it?

Most everyone would agree itís unrealistic to expect a world without some unhappiness, but we Americans may be setting the tolerance level too low. The fact is, overcoming adversity, unhappiness and discomfort builds good self-esteem and resilience to the problems everyday life throws at us. Many of those problems are transient and manageable. When we feel depressed, anxious or emotionally uncomfortable, medication isnít usually necessary.

Chronic or significant problems naturally lead to more unhappiness, but medication still may not be the best treatment. Good psychotherapy is non-intrusive and gives clients coping skills that may last a lifetime. If true happiness is the goal, psychotherapy is most often the best treatment. Clients realize even happy people feel unhappy and miserable sometimes. Itís how they get through it and manage their emotional equilibrium that may be different.

From a non-physician point of view, there is definitely a place for mental health medication. At this point in time, properly diagnosed ADHD is considered by most to be best treated with meds. However, anxiety, some processing disorders and even rambunctious children are incorrectly diagnosed and take unnecessary medication. Many MH professionals agree medication is necessary for some types of depression and anxiety, especially those with a genetic basis or with symptoms that impair regular functioning.

Most all severe emotional and psychiatric illnesses, such as bipolar disorder and psychosis, require medication. Properly diagnosed clients who receive the right medication often experience relief they would never get from psychotherapy. In other words, some people need mental health medication. Similarly, many people with bona fide chronic and acute physical pain need appropriately prescribed medication, including opioids.

We are fortunate to live in a country that has so many helpful medications available. Still, prescribing is usually based on patient report, and physicians who want their patients to feel better may be too quick to choose medication.

Craig D. Weiss, Ph.D., is a partner at Sywulak and Weiss Psychological Associates, a Child, Family and Forensic practice in Upper Southampton.

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